MRCPsychmentor Flashcards
Which antipsychotics are most, least and sparing for hyperprolactinaemia?
Most:
- Risperidone
- Paliperidone
- Amisulpride
- Sulpride
Low risk
- Olanzapine
- Lurasidne
- Ziprasidone
Sparing:
- Clozapine
- Aripiprazole
- Asenapine
- Quetiapine
Which SSRI’s are associated with least drug interactions
Citalopram (least) + Sertraline (second)
What is pseudocyesis?
A condition where a woman believes she is pregnant when she is not - not couvade syndrome (conversion symptoms in partners of expectant women who are away they are not pregnant)
Differentiate the phi-phenomenon from autokinesis?
Autokinesis - one single light in the darkness appears it is moving
Phi-phenomenon - rapid sequences of perceptual events that give the impression of movement Wh
Which part of the cell is devoted to the manufacture of lipids?
Smooth endoplasmic reticulum
n.b the Nissl substance that contains the rough endoplasmic reticulum and ribosomes is the site of protein synthesis
Amitriptyline or haloperidol - which is more likely to precipitate heart block?
Amitriptyline - TCA’s more associated with heart block
Antipsychotics more associated with torsades des pointes and VF
Why may U waves been seen in anorexia nervosa?
They are produced in hypokalaemia
What makes up the MMSE?
Orientation to place
Orientation to time
Registration - 3 items to name
Attention and concentration - serial 7’s or WORLD backwards
Recall
Language
- name a pencil and watch
- repeat sentances no ifs and or buts
- give a 3 stage command
Visual construction
- draw intersecting pentagons
Name some anti-depressants low risk to cause hyponatraemia
- Moclobemide (MAOIs)
- NaSSa
- Buproprion
- Agomelatine
n.b TCAs are moderate risk, SSRI/SNRI are high risk for hyponatraemia
What enzymes are involved in the aetiology of alcohol brain damage?
Transketolase
Also:
- Pyruvate dehydrogenase (PDH)
- Alphaketoglutarate dehydrogenase (KGDH
What schizophrenia related protein codes for an enzyme involved in the biogenesis of lysome related organelles and is found in brain and muscle?
DNTB1 - Dysbidin - on chromosome 6
How do V2 and V3 exit the skull?
V2 - round foramen
V3 - ovale foramen
I - cribiform plate
II - optic canal
III, IV, V1, VI - SOF
VII + VIII = internal auditory canal
IX, X, XI - jugular foramen
XII - hypoglossal canal
How do Chimeras differ from Moasics
Mosaics - different cell types from one zygote
Chimera - different cell types from more than one zygote
Are cannabinoid receptors found in the brainstem?
No
What does the Clifton Assessment Procedure assess?
Quality of life, cognitive needs and physical dependency levels in the elderly
It includes a behavioural and cognitive scale
Can be used for hospital and community settings
Which APOE increases risk?
APOE4 - on chromosome 19
Is CSF more acidic than plasma?
Yes
How often do the following EPSEs occur per year of antipsychotic exposure:
a) Dystonia
b) Pseudo-parkinsonism
c) Akasthesia
d) Tardive Dyskinesia
a) 10%
b) 20%
c) 25%
d) 5%
Akasthesia highest incidence - 25%
Parkinsonism second - 20%
Dystonia 3rd - 10%
Tardive Dyskinesia 4th - 5%
Are endophenotypes state dependent?
No - endophenotypes should be present regardless of illness/remission state
Other features:
- Heritable
- Be present in higher rates of disease families > general population
- Cosegregate with the disorder within families
- Endophenotypes must segregate within the illness in the general population
- Must be reliably be measured
What scale does the AMDISEN measure?
Lithium toxicity
What is a test like the Wisconsin card sorting test for objects?
Goldstein-Scheerer object sorting task
It is a test if abstract function
What is the blood supply to the hypothalamus?
Anterior communicating artery?
What is the blood supply to the basal ganglia?
Medial cerebral artery
What MRI findings may be present in MS?
White matter hypointensities
The anti-emetic effect in chlorpromazine is due to…
D2 blockade in the CTZ
For OCD which symptom domains respond poorly to SSRIs and CBT?
Sexual/religious rituals and hoarding rituals
Note symmetry/ordering rituals have a high genetic risk
How long does cannabis, cocaine, methadone, heroin be found on a UDS?
Cannabis 1-3 days if occasional up to 30 days if chronic
Cocaine 6-8hrs with metabolites 2-4 days
Amphetamine up to 48hrs
Heroin 1-3 days, Methadone up to 7 days
Which neurological disorder has substance P been linked to?
Huntington’s - lower levels
Which condition has neurotensin been linked to?
Psychosis
In Fragile X intelligence deficits correlate to….
the degree of chromosomal damage
Name some urgent treatments for trancylpromine?
Phentolamine or Chlorpromazine: alpha-adrenergic antagonist - these lower BP within 5 mins if given IV
A craboxyl ester group is present on….
depot antipsychotics
Large family size and smoking during pregnancy are high risk factors for….
language development delay
Hyperhomocysteinaemia is associated with…
Dementia
